MEDICARE: JEAN MARIE DOAN NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	RN85266	CO

General Provider Information

NPI Number	:	1528253895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN MARIE DOAN NP-C

Provider Business Mailing Address
First Line	:	325 E FONTANERO ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-7521
Country	:	US
Telephone Number	:	719-636-3829
Fax Number	:	719-636-1387

Provider Business Practice Location Address
First Line	:	325 E FONTANERO ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-7521
Country	:	US
Telephone Number	:	719-636-3829
Fax Number	:	719-636-1387

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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